For selected patients with low risk disease, they have the option of accelerated partial breast irradiation. In this procedure, a smaller volume of breast tissue around the original tumour location only is irradiated. This allow the treatment to proceed at a faster pace, shortening what used to take 4-6 weeks to just 1 week or even to a single fraction.
Evidence for this APBI is increasing in recent years with the publication of medium term results from randomized clinical trials. Long terms results are available from single institution experience as well
Careful selection of patients is extremely important. Various professional bodies have published recommended selection criteria. In general, suitable patients are usually older (age >45 years), with unifocal tumours of about 2-3cm in diameter, and which have been excised with clear margins and no nodal involvement by conventional nodal staging procedures.
Some of these APBI techniques is illustrated below.
- Multicatheter Brachytherapy
- External Beam APBI